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2015 ; 3
(2
): 127-33
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Dermatologic Extrahepatic Manifestations of Hepatitis C
#MMPMID26357639
Dedania B
; Wu GY
J Clin Transl Hepatol
2015[Jun]; 3
(2
): 127-33
PMID26357639
show ga
Hepatitis C virus (HCV) affects millions of people worldwide, and an estimated
3.2 million people in the United States. HCV is a hepatotropic and lymphotropic
virus that causes not only liver disease, but also a significant number of
extrahepatic manifestations (EHMs). Up to 74% of patients affected by HCV will
have HCV-related EHMs of some severity in their lifetime. The EHMs vary from
simple cutaneous palpable purpura to complex lymphoproliferative disorders,
including lymphomas and immune-complex deposit diseases causing local and/or
systemic complications. Mixed cryoglobulinemia (MC) is manifested by multiple
systemic organ involvement, mainly skin, kidney, peripheral nerves, and salivary
glands, and less frequently causes widespread vasculitis and malignant lymphoma.
MC affects up to 3% of HCV-infected patients with cryoglobulinemia of clinical
significance, i.e. >6%. Severe disease requires immunosuppressive or plasma
exchange therapy. HCV prevalence in the United States in patients with porphyria
cutanea tarda (PCT) was reported to be 66%, much higher than that in general
population. Therefore, all patients with PCT should be screened for HCV. The skin
rash of PCT varies from large blisters to small vesicles and/or milia on the
hands. Skin manifestations due to PCT usually respond to anti-HCV treatment
together with reducing skin sun exposure, avoiding triggers, having routine
phlebotomy (especially for people with chronic iron overload states), and using
chloroquine. Lichen planus (LP), which typically affects both the skin and oral
mucosa is a chronic inflammatory disease of squamous cell origin affecting about
1% of the worldwide population. The prevalence of HCV in patients with LP varies
based on geographic location. We review here the basic pathophysiology, clinical
features, and management of dermatologic manifestations of HCV.
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